OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS FROM VULNERABLE POPULATIONS: THE SUCCESS OF PATIENT PRIORITIES CARE

Abstract As older adults in the USA grow more diverse, equitable translation of knowledge and best practices to vulnerable groups is essential. Older adults with multiple chronic conditions (MCC) benefit from care focused on the health priorities of individuals. Health priorities include: 1) core values that provide meaning to life; 2) specific, actionable, and realistic health goals that reflect these values; and 3) care preferences that include what individuals are able and willing to do (or not) to achieve their goals. For vulnerable older adults, adverse life experiences provide context to their values. A diverse panel will review the Patient Priorities Care (PPC) approach and describe how PPC has been successfully adapted at different institutions. The first presentation will describe PPC and the importance of identifying values, goals, and health preferences for older adults with MCC. The presenter will show that PPC improves outcomes among older adults, their families, and healthcare providers. The second presentation will describe the implementation of PPC in the VA system. The presenter will describe the impact of PPC and efforts to disseminate it. The third and fourth presentations will describe the cultural adaptation of PPC for older African Americans and older Hispanics respectively. The presenters will describe the adaptation process and discuss the barriers they faced, and the lessons learned from each population group. The panel will conclude by providing suggestions on how to disseminate and increase the adoption of PPC to identify what matters most for diverse older adults.

depending on the quality of the relationship.Cross-sectional and longitudinal studies have shown that loneliness (defined as a subjectively perceived deficiency in a person's social relationship) is more pronounced in low-quality relationships.
Little is known about daily sources of loneliness within a couple.To explore this question, we investigated whether low-quality activities in a partnership can lead to feelings of loneliness in daily situations.To examine this question, we analyzed data from 72 individuals (M age = 43 years, range = 18 -82 years; 64% female) who provided 576 measurement occasions on seven consecutive days in which they were involved in activities with their romantic partners.Participants indicated how they experienced the activity in each situation (positively or negatively) and how lonely they felt.Results showed that participants who reported lowerquality activities with their partner reported higher levels of daily loneliness (47% explained variance); and on occasions when participants reported lower-quality activities than usual, they also reported higher levels of loneliness (25% explained variance).Moreover, individuals who reported higher levels of loneliness during the 7-day assessment benefited less from high-quality activities with their partner in terms of reduced loneliness.Thus, loneliness not only results from, but also contributes to, how people experience daily activities with their partners.Gender and age had no effect on these associations, suggesting generalizability of the results.

OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS FROM VULNERABLE POPULATIONS: THE SUCCESS OF PATIENT PRIORITIES CARE
Chair: Rafael Samper-Ternent Discussant: Lee Jennings As older adults in the USA grow more diverse, equitable translation of knowledge and best practices to vulnerable groups is essential.Older adults with multiple chronic conditions (MCC) benefit from care focused on the health priorities of individuals.Health priorities include: 1) core values that provide meaning to life; 2) specific, actionable, and realistic health goals that reflect these values; and 3) care preferences that include what individuals are able and willing to do (or not) to achieve their goals.For vulnerable older adults, adverse life experiences provide context to their values.A diverse panel will review the Patient Priorities Care (PPC) approach and describe how PPC has been successfully adapted at different institutions.The first presentation will describe PPC and the importance of identifying values, goals, and health preferences for older adults with MCC.The presenter will show that PPC improves outcomes among older adults, their families, and healthcare providers.The second presentation will describe the implementation of PPC in the VA system.The presenter will describe the impact of PPC and efforts to disseminate it.The third and fourth presentations will describe the cultural adaptation of PPC for older African Americans and older Hispanics respectively.The presenters will describe the adaptation process and discuss the barriers they faced, and the lessons learned from each population group.The panel will conclude by providing suggestions on how to disseminate and increase the adoption of PPC to identify what matters most for diverse older adults.

ADAPTATION OF THE PPC APPROACH FOR HISPANIC OLDER ADULTS
Rafael Samper-Ternent 1 , Gilberto Perez 1 , Melissa deCardi Hladek 2 , and Carolina Fonseca 3 , 1. UTHealth Houston, Houston, Texas, United States, 2. Johns Hopkins School of Nursing,Baltimore,Maryland,United States,3. Harvard Medical School,Boston,Massachusetts,United Sta tes Older Hispanics have a high prevalence of MCC, contributing to a higher risk for dementia.As a result, there is a rapid increase in the number of young Hispanics assuming caregiver roles.The caregiver role is a cultural expectation among Hispanics and caregiving by the family is preferred over professional caregiving.There is limited information on how the unique context of Hispanics impacts the dyadic interactions between older adults and their care partners.There is a gap in the literature on how health values among Hispanics frame their healthcare goals and preferences and whether care partner involvement impacts the identification of these goals and preferences.There is also a limited number of evidence-based interventions that can help shift the current healthcare paradigm from clinical-guideline-based care to patient-centered care for underrepresented older adults.Thus, we used the Heuristic Framework to culturally adapt PPC for Hispanics with MCC and cognitive impairment living in Texas and embed it in two Geriatrics Clinics.We will describe the adaptation and implementation process and share findings from a pragmatic pilot study with 25 older Hispanics that participated in the PPC approach.We will share the outcomes from this pilot and the feedback received from patients, caregivers, and clinicians on the implementation of PPC at these clinics.We will conclude by sharing the current plans to expand the outreach of PPC for diverse older adult populations.

PATIENT PRIORITIES CARE: THE PAST, THE PRESENT, AND THE FUTURE Aanand Naik, University of Texas Health Science Center at Houston, Houston, Texas, United States
Healthcare based on patient goals can improve the care of older adults, particularly those with MCC.Prior studies have identified five healthcare values that guide how patients establish healthcare goals and make medical decisions: 1) Self-sufficiency, 2) Enjoyment, 3) Connection, 4) Balancing quality and length of life, 5) Engagement in care.The Patient Priorities Care (PPC) approach is an evidence-based approach that allows patients to identify their healthcare values, or what matters most to them, and identify one thing, the most important goal they want to address based on their healthcare preferences.We have demonstrated that PPC is feasible and results in less burdensome care, including fewer medications and referrals to specialists.In the VA system, we have also shown that PPC helps clinicians recommend home and community services that are aligned with the patient's priorities.To enhance its relevance for Veterans, African Americans, and Hispanics, a deliberate effort to